中国血液流变学杂志
中國血液流變學雜誌
중국혈액류변학잡지
CHINESE JOURNAL OF HEMORHEOLOGY
2013年
2期
327-330
,共4页
毛圆圆%刘琴%张雪刚%陈友国
毛圓圓%劉琴%張雪剛%陳友國
모원원%류금%장설강%진우국
子宫内膜异位症%更年期指数%疼痛视觉模拟评分%CA125
子宮內膜異位癥%更年期指數%疼痛視覺模擬評分%CA125
자궁내막이위증%경년기지수%동통시각모의평분%CA125
endometriosis%Kupperman Menopausal Index%Visual Analogue Score%CA125
目的通过对子宫内膜异位症(Endometriosis,EMs)腹腔镜术后行GnRH-α和反向添加治疗(Add Back Therapy,ABT),观察患者更年期指数(Kupperman Menopausal Index,KMI)、疼痛视觉模拟评分(Visual Analogue Score,VAS)、以及血清CA125阳性率与停药后复发率。方法选取2009年10月~2010年12月在苏州大学附属第一医院患卵巢巧克力囊肿行腹腔镜手术者的育龄妇女为研究对象,按美国生育学会(AFS)分期标准,选取Ⅲ期和Ⅳ期共45例。其中使用GnRH-α治疗3个月15例(A组),6个月15例(B组),6个月ABT 15例(C组)。结果总体上看,经期疼痛VAS在分组之间没有统计学意义(F=0.20,P=0.8188),而在手术前后有统计学意义。术前、术后第1天及术后3个月时点,KMI在3组之间没有统计学差异,而随访6个月时点,KMI在B组和C组之间有统计学意义(F=77.13,P<0.01)。重复测量分析结果显示(仅对B组和C组),时间效应有统计学意义(F=387.16,P<0.01)。B组KMI随着时间而逐渐升高,C组亦表现出随时间变化而升高趋势。血清CA125阳性率术后明显低于术前(χ2=38.05,P<0.01);CA125阳性率在3组之间的分布则没有统计学意义(χ2=1.5144,P=0.4690)。虽然A组复发率偏高(40%),但是复发率在3组之间的分布没有达到统计学显著水平(χ2=0.8295,P=0.6605)。结论腹腔镜术后联合GnRH-α及ABT是治疗EMs患者的有效手段。
目的通過對子宮內膜異位癥(Endometriosis,EMs)腹腔鏡術後行GnRH-α和反嚮添加治療(Add Back Therapy,ABT),觀察患者更年期指數(Kupperman Menopausal Index,KMI)、疼痛視覺模擬評分(Visual Analogue Score,VAS)、以及血清CA125暘性率與停藥後複髮率。方法選取2009年10月~2010年12月在囌州大學附屬第一醫院患卵巢巧剋力囊腫行腹腔鏡手術者的育齡婦女為研究對象,按美國生育學會(AFS)分期標準,選取Ⅲ期和Ⅳ期共45例。其中使用GnRH-α治療3箇月15例(A組),6箇月15例(B組),6箇月ABT 15例(C組)。結果總體上看,經期疼痛VAS在分組之間沒有統計學意義(F=0.20,P=0.8188),而在手術前後有統計學意義。術前、術後第1天及術後3箇月時點,KMI在3組之間沒有統計學差異,而隨訪6箇月時點,KMI在B組和C組之間有統計學意義(F=77.13,P<0.01)。重複測量分析結果顯示(僅對B組和C組),時間效應有統計學意義(F=387.16,P<0.01)。B組KMI隨著時間而逐漸升高,C組亦錶現齣隨時間變化而升高趨勢。血清CA125暘性率術後明顯低于術前(χ2=38.05,P<0.01);CA125暘性率在3組之間的分佈則沒有統計學意義(χ2=1.5144,P=0.4690)。雖然A組複髮率偏高(40%),但是複髮率在3組之間的分佈沒有達到統計學顯著水平(χ2=0.8295,P=0.6605)。結論腹腔鏡術後聯閤GnRH-α及ABT是治療EMs患者的有效手段。
목적통과대자궁내막이위증(Endometriosis,EMs)복강경술후행GnRH-α화반향첨가치료(Add Back Therapy,ABT),관찰환자경년기지수(Kupperman Menopausal Index,KMI)、동통시각모의평분(Visual Analogue Score,VAS)、이급혈청CA125양성솔여정약후복발솔。방법선취2009년10월~2010년12월재소주대학부속제일의원환란소교극력낭종행복강경수술자적육령부녀위연구대상,안미국생육학회(AFS)분기표준,선취Ⅲ기화Ⅳ기공45례。기중사용GnRH-α치료3개월15례(A조),6개월15례(B조),6개월ABT 15례(C조)。결과총체상간,경기동통VAS재분조지간몰유통계학의의(F=0.20,P=0.8188),이재수술전후유통계학의의。술전、술후제1천급술후3개월시점,KMI재3조지간몰유통계학차이,이수방6개월시점,KMI재B조화C조지간유통계학의의(F=77.13,P<0.01)。중복측량분석결과현시(부대B조화C조),시간효응유통계학의의(F=387.16,P<0.01)。B조KMI수착시간이축점승고,C조역표현출수시간변화이승고추세。혈청CA125양성솔술후명현저우술전(χ2=38.05,P<0.01);CA125양성솔재3조지간적분포칙몰유통계학의의(χ2=1.5144,P=0.4690)。수연A조복발솔편고(40%),단시복발솔재3조지간적분포몰유체도통계학현저수평(χ2=0.8295,P=0.6605)。결론복강경술후연합GnRH-α급ABT시치료EMs환자적유효수단。
Objective To evaluate the effects of endometriosis with laparoscopic operation after GnRH-αand Add Back Therapy(ABT) in Kupperman Menopausal Index(KMI),Visual Analogue Score(VAS),positive rate of CA125,and the recurrence rate.Methods Forty-ifve women with endometriosis were diagnosed by surgery(AFSⅢ~Ⅳ) in the First Affiliated Hospital of Soochow University between October 2009 to December 2010. The participants were assigned into three groups randomly(15 patients each),only using GnRH-α for three months(Group-A),for six months(Group-B) and GnRH-αwith ABT(Group-C).Results VAS had no statistical significance in three groups(F=0.20,P=0.8188),but showed statistical significance between pre-operation and post-operation.As for KMI,in the time of pre-operation,post-operation of the ifrst day and 3 month,there had no statistical signiifcance.ABT group had lower KMI comparing with non-ABT group for 6 month.Repeated analysis suggesting time effects were influenced KMI level(F=387.16,P<0.01),KMI level increased with the time for non-ABT group,and ABT group showed the same tendency.The positive of serum CA125 in post-operation was lower as compared with pre-operation(χ2=38.05,P<0.01),and the positive frequency of serum CA125 among three groups were of no statistical significance(χ2=1.5144,P=0.4690).As for recurrence,there were no statistical significance among three groups,although the third month therapy group was mild higher(40%).Conclusion GnRH-αcombined with ABT therapy after laparoscopic was the effective measures.